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. 2023 Sep 13:10:1247146.
doi: 10.3389/fcvm.2023.1247146. eCollection 2023.

Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies

Gilberto Campos Guimarães Filho  1 , Priscila Valverde de Oliveira Vitorino  2 , Sayuri Inuzuka  1 , Adriana Sebba Barroso  1 , Robson Pierre Pacífico Alves Filho  1 , Victoria Alves Melo  1 , Luiz Fernando de Oliveira Urzeda  1 , Ana Luiza Lima Sousa  1 , Antonio Coca  3 , Paulo César Brandão Veiga Jardim  1 , Weimar Kunz Sebba Barroso  1
Affiliations

Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies

Gilberto Campos Guimarães Filho et al. Front Cardiovasc Med. .

Abstract

Background: Arterial hypertension treatment guided by central blood pressures (CPB) rather than peripheral blood pressures (PBP) measurement has the potential to show greater effectiveness in preventing or even regressing stiffness and target organ damage (TOD).

Objective: This study aimed to compare the parameters of CBP and PBP measurements, arterial stiffness, TOD and renal profile in patients with anti-hypertensive treatment guided by CBP or PBP targets.

Methods: A randomized clinical trial was conducted in central group (CG) and peripheral group (PG). Patients were randomized, evaluated every 3 months for BP and antihypertensive adjustments during a one-year follow up. The procedures in V1 and V5: anthropometric assessment; CBP/PBP measurements, carotid ultrasound; echocardiography; laboratory tests. Paired and unpaired t-tests and the χ2 were used (significance level: 5%).

Results: The study evaluated 59 participants (30CG/29PG). The augmentation index (AIx) was higher in the CG (27.3% vs. 20.3%, p = 0.041). Intergroup analysis has found central diastolic BP lower in the CG (78.9 vs. 84.3 mmHg, p = 0.024) and the Alx difference between groups ceased to exist after a one-year follow-up. Intragroup comparisons, after intervention, showed a lower frequency of changed PWV (p < 0.001) and LVMI (p = 0.018) in the CG. The PG showed a higher frequency of changed PWV (p < 0.001) and LVMI (p = 0.003).

Conclusion: The intervention guided by central BP reduced the central diastolic BP and AIx compared to the PG. There was a reduction in the frequency of changed PWV and LVMI in the CG.

Keywords: arterial stiffness; central blood pressure; clinical trial; hypertension; pulse wave velocity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Central diastolic pressure and augmentation index values at V1 (initial) and V5 (final) in the CG and PG, n = 59. CG, central group; PG, peripheral group.
See this image and copyright information in PMC

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